Health
Advisory
CDC UPDATES RECOMMENDATIONS FOR THE AMOUNT OF TIME PERSONS WITH INFLUENZA-LIKE ILLNESS SHOULD BE
AWAY FROM OTHERS

The Delaware Division of Public Health is passing on this Health Advisory from the Centers for Disease Control and Prevention.

On August 5, 2009, CDC changed its recommendation related to the amount of time people with influenza-like illness should stay away from
others (the exclusion period). New guidance indicates that people with influenza-like illness should stay home for at least 24 hours
after their fever is gone (without the use of fever-reducing medicine). A fever is defined as having a temperature of 100° Fahrenheit
or 37.8° Celsius or greater.

This is a change from the previous recommendation that ill persons stay home for 7 days after illness onset or until 24 hours after the
resolution of symptoms, whichever was longer.

The new recommendation applies to camps, schools, businesses, mass gatherings, and other community settings where the majority of people
are not at increased risk for influenza complications. CDC recommends this exclusion period regardless of whether or not antiviral
medications are used. This guidance does not apply to health care settings where the exclusion period continues to be for 7 days from
symptom onset or until 24 hours after the resolution of symptoms, whichever is longer. (See http://www.cdc.gov/h1n1flu/guidelines_infection_control.htm for
guidance on infection control in health care settings.)

Decisions about extending the exclusion period should be made at the community level, in conjunction with local and state health
officials. More stringent guidelines and longer periods of exclusion – for example, until complete resolution of all symptoms
– may be considered for people returning to a setting where high numbers of high-risk people may be exposed.

This exclusion period guidance for the community setting is based on epidemiologic data about the overall risk of severe illness and
death. The new recommendation attempts to balance the risks of acquiring illness from influenza and the potential benefits of decreasing
transmission through the exclusion of ill persons with the goal of minimizing social disruption. This guidance will continue to be
updated as more information becomes available.